CA2651684C - Peptide compounds for treating refractory status epilepticus - Google Patents

Peptide compounds for treating refractory status epilepticus Download PDF

Info

Publication number
CA2651684C
CA2651684C CA2651684A CA2651684A CA2651684C CA 2651684 C CA2651684 C CA 2651684C CA 2651684 A CA2651684 A CA 2651684A CA 2651684 A CA2651684 A CA 2651684A CA 2651684 C CA2651684 C CA 2651684C
Authority
CA
Canada
Prior art keywords
use according
seizures
compound
group
refractory
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Expired - Fee Related
Application number
CA2651684A
Other languages
English (en)
French (fr)
Other versions
CA2651684A1 (en
Inventor
Thomas Stoehr
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
UCB Pharma GmbH
Original Assignee
UCB Pharma GmbH
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Family has litigation
First worldwide family litigation filed litigation Critical https://patents.darts-ip.com/?family=36889233&utm_source=google_patent&utm_medium=platform_link&utm_campaign=public_patent_search&patent=CA2651684(C) "Global patent litigation dataset” by Darts-ip is licensed under a Creative Commons Attribution 4.0 International License.
Application filed by UCB Pharma GmbH filed Critical UCB Pharma GmbH
Publication of CA2651684A1 publication Critical patent/CA2651684A1/en
Application granted granted Critical
Publication of CA2651684C publication Critical patent/CA2651684C/en
Expired - Fee Related legal-status Critical Current
Anticipated expiration legal-status Critical

Links

Classifications

    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00Medicinal preparations containing organic active ingredients
    • A61K31/33Heterocyclic compounds
    • A61K31/395Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins
    • A61K31/55Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having seven-membered rings, e.g. azelastine, pentylenetetrazole
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00Medicinal preparations containing organic active ingredients
    • A61K31/16Amides, e.g. hydroxamic acids
    • A61K31/165Amides, e.g. hydroxamic acids having aromatic rings, e.g. colchicine, atenolol, progabide
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00Medicinal preparations containing organic active ingredients
    • A61K31/33Heterocyclic compounds
    • A61K31/395Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins
    • A61K31/40Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having five-membered rings with one nitrogen as the only ring hetero atom, e.g. sulpiride, succinimide, tolmetin, buflomedil
    • A61K31/4015Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having five-membered rings with one nitrogen as the only ring hetero atom, e.g. sulpiride, succinimide, tolmetin, buflomedil having oxo groups directly attached to the heterocyclic ring, e.g. piracetam, ethosuximide
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00Medicinal preparations containing organic active ingredients
    • A61K31/33Heterocyclic compounds
    • A61K31/395Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins
    • A61K31/55Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having seven-membered rings, e.g. azelastine, pentylenetetrazole
    • A61K31/551Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having seven-membered rings, e.g. azelastine, pentylenetetrazole having two nitrogen atoms, e.g. dilazep
    • A61K31/55131,4-Benzodiazepines, e.g. diazepam or clozapine
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K38/00Medicinal preparations containing peptides
    • A61K38/04Peptides having up to 20 amino acids in a fully defined sequence; Derivatives thereof
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K45/00Medicinal preparations containing active ingredients not provided for in groups A61K31/00 - A61K41/00
    • A61K45/06Mixtures of active ingredients without chemical characterisation, e.g. antiphlogistics and cardiaca
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K9/00Medicinal preparations characterised by special physical form
    • A61K9/0012Galenical forms characterised by the site of application
    • A61K9/0053Mouth and digestive tract, i.e. intraoral and peroral administration
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61PSPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P25/00Drugs for disorders of the nervous system
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61PSPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P25/00Drugs for disorders of the nervous system
    • A61P25/08Antiepileptics; Anticonvulsants
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61PSPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P25/00Drugs for disorders of the nervous system
    • A61P25/08Antiepileptics; Anticonvulsants
    • A61P25/12Antiepileptics; Anticonvulsants for grand-mal
    • GPHYSICS
    • G01MEASURING; TESTING
    • G01NINVESTIGATING OR ANALYSING MATERIALS BY DETERMINING THEIR CHEMICAL OR PHYSICAL PROPERTIES
    • G01N33/00Investigating or analysing materials by specific methods not covered by groups G01N1/00 - G01N31/00
    • G01N33/48Biological material, e.g. blood, urine; Haemocytometers
    • G01N33/50Chemical analysis of biological material, e.g. blood, urine; Testing involving biospecific ligand binding methods; Immunological testing
    • G01N33/68Chemical analysis of biological material, e.g. blood, urine; Testing involving biospecific ligand binding methods; Immunological testing involving proteins, peptides or amino acids
    • G01N33/6893Chemical analysis of biological material, e.g. blood, urine; Testing involving biospecific ligand binding methods; Immunological testing involving proteins, peptides or amino acids related to diseases not provided for elsewhere
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K2300/00Mixtures or combinations of active ingredients, wherein at least one active ingredient is fully defined in groups A61K31/00 - A61K41/00

Landscapes

  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Chemical & Material Sciences (AREA)
  • Medicinal Chemistry (AREA)
  • General Health & Medical Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Pharmacology & Pharmacy (AREA)
  • Engineering & Computer Science (AREA)
  • Epidemiology (AREA)
  • Biomedical Technology (AREA)
  • Immunology (AREA)
  • Bioinformatics & Cheminformatics (AREA)
  • Proteomics, Peptides & Aminoacids (AREA)
  • Hematology (AREA)
  • Urology & Nephrology (AREA)
  • Molecular Biology (AREA)
  • Chemical Kinetics & Catalysis (AREA)
  • General Chemical & Material Sciences (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Organic Chemistry (AREA)
  • Neurosurgery (AREA)
  • Neurology (AREA)
  • Food Science & Technology (AREA)
  • Cell Biology (AREA)
  • Microbiology (AREA)
  • Biotechnology (AREA)
  • Pain & Pain Management (AREA)
  • Gastroenterology & Hepatology (AREA)
  • Physics & Mathematics (AREA)
  • Analytical Chemistry (AREA)
  • Biochemistry (AREA)
  • General Physics & Mathematics (AREA)
  • Pathology (AREA)
  • Nutrition Science (AREA)
  • Physiology (AREA)
  • Pharmaceuticals Containing Other Organic And Inorganic Compounds (AREA)
  • Acyclic And Carbocyclic Compounds In Medicinal Compositions (AREA)
  • Medicines That Contain Protein Lipid Enzymes And Other Medicines (AREA)
CA2651684A 2006-06-15 2007-06-15 Peptide compounds for treating refractory status epilepticus Expired - Fee Related CA2651684C (en)

Applications Claiming Priority (5)

Application Number Priority Date Filing Date Title
US81396706P 2006-06-15 2006-06-15
US60/813,967 2006-06-15
EP06013655.3 2006-06-30
EP06013655A EP1873527A1 (de) 2006-06-30 2006-06-30 Verfahren zur Identifizierung von CRMP-Modulatoren
PCT/EP2007/005306 WO2007144196A2 (en) 2006-06-15 2007-06-15 Peptide compounds for treating refractory status epilepticus

Publications (2)

Publication Number Publication Date
CA2651684A1 CA2651684A1 (en) 2007-12-21
CA2651684C true CA2651684C (en) 2017-09-12

Family

ID=36889233

Family Applications (1)

Application Number Title Priority Date Filing Date
CA2651684A Expired - Fee Related CA2651684C (en) 2006-06-15 2007-06-15 Peptide compounds for treating refractory status epilepticus

Country Status (21)

Country Link
US (3) US20100273714A1 (de)
EP (2) EP1873527A1 (de)
JP (1) JP5795145B2 (de)
KR (2) KR20090030307A (de)
CN (3) CN101636180B (de)
AR (1) AR061475A1 (de)
AU (1) AU2007260208B2 (de)
BR (1) BRPI0713702A2 (de)
CA (1) CA2651684C (de)
CY (1) CY1118523T1 (de)
DK (1) DK2035029T3 (de)
EA (1) EA018607B1 (de)
ES (1) ES2613931T3 (de)
HU (1) HUE033180T2 (de)
LT (1) LT2035029T (de)
MX (1) MX2008015951A (de)
PL (1) PL2035029T3 (de)
PT (1) PT2035029T (de)
SI (1) SI2035029T1 (de)
TW (1) TWI422384B (de)
WO (1) WO2007144196A2 (de)

Families Citing this family (22)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
ES2185606T3 (es) * 2001-03-21 2003-05-01 Sanol Arznei Schwarz Gmbh Nuevo uso de una clase de compuestos peptidicos para tratamiento de la alodinia u otros tipos diferentes de dolor cronico o fantasma.
US20100256179A1 (en) * 2004-03-26 2010-10-07 Ucb Pharma Gmbh Combination therapy for pain in painful diabetic neuropathy
US8008351B2 (en) * 2004-04-16 2011-08-30 Ucb Pharma Gmbh Methods for prophylaxis or treatment of conditions associated with cortical spreading depression
EP1604655A1 (de) 2004-06-09 2005-12-14 Schwarz Pharma Ag Neue Verwendung von Peptidverbindungen zur Behandlung von Trigeminusneuralgie
NZ552651A (en) * 2004-08-27 2010-07-30 Sanol Arznei Schwarz Gmbh Novel use of peptide compounds for treating bone cancer pain, chemotherapy-and nucleoside-induced pain
EP1642889A1 (de) * 2004-10-02 2006-04-05 Schwarz Pharma Ag Verbessertes Syntheseschema für Lacosamid
EP1754476A1 (de) * 2005-08-18 2007-02-21 Schwarz Pharma Ag Lacosamid (SPM 927) zur Behandlung von Myalgien, z.B. Fibromyalgie
EP2037965B1 (de) 2006-06-15 2017-08-30 UCB Pharma GmbH Pharmazeutische zusammensetzung mit synergistischer antikonvulsiver wirkung
EP1873527A1 (de) 2006-06-30 2008-01-02 Schwarz Pharma Ag Verfahren zur Identifizierung von CRMP-Modulatoren
CN101466390B (zh) 2006-06-15 2014-03-12 优时比制药有限公司 用于治疗难治性癫痫持续状态的肽类化合物
WO2009053070A1 (en) * 2007-10-23 2009-04-30 Schwarz Pharma Ag Compounds for treating demyelination conditions
US8829033B2 (en) 2009-09-23 2014-09-09 The University Of North Carolina At Chapel Hill N-benzylamide substituted derivatives of 2-(acylamido)acetic acid and 2-(acylamido)propionic acids: potent neurological agents
EP2378291A1 (de) 2010-04-15 2011-10-19 UCB Pharma GmbH Lacosamid-Nachweisassay
EP2468261A1 (de) 2010-12-02 2012-06-27 UCB Pharma GmbH Formulierung von Lacosamid
AU2011335415B2 (en) 2010-12-02 2016-05-19 Ucb Pharma Gmbh Once daily formulation of lacosamide
JP6061935B2 (ja) * 2011-09-14 2017-01-18 ザ ヘンリー エム. ジャクソン ファウンデーション フォー ザ アドバンスメント オブ ミリタリー メディシン,インコーポレーテッド 心的外傷後ストレス障害(ptsd)のための診断用バイオマーカーを検出及び監視するため、並びに同障害の自殺型と非自殺型とを識別するためのプロセス及びキット
US12023322B2 (en) 2015-12-11 2024-07-02 Aarhus Universitet Rufinamide for use in the treatment of myotonia
MX2018008021A (es) 2015-12-30 2018-11-09 Adamas Pharmaceuticals Inc Metodos y composiciones para el tratamiento de trastornos relacionados con convulsiones.
JP2019525947A (ja) 2016-06-01 2019-09-12 エムスリー・バイオテクノロジー・インコーポレイテッドM3 Biotechnology, Inc. 化合物
US11278634B1 (en) 2021-02-12 2022-03-22 Extrovis Ag Stable parenteral composition of lacosamide
US11806405B1 (en) 2021-07-19 2023-11-07 Zeno Management, Inc. Immunoconjugates and methods
WO2023178250A1 (en) * 2022-03-17 2023-09-21 SpringWorks Therapeutics Inc. Treatment of tuberous sclerosis with mirdametinib

Family Cites Families (35)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US813967A (en) 1905-07-27 1906-02-27 John W Hart Self-igniting match-safe.
US4736866A (en) * 1984-06-22 1988-04-12 President And Fellows Of Harvard College Transgenic non-human mammals
US5378729A (en) * 1985-02-15 1995-01-03 Research Corporation Technologies, Inc. Amino acid derivative anticonvulsant
US5585358A (en) * 1993-07-06 1996-12-17 Yissum Research Development Corporation Of The Hebrew University Of Jerusalem Derivatives of valproic acid amides and 2-valproenoic acid amides, method of making and use thereof as anticonvulsant agents
DE69729392T2 (de) 1996-03-15 2005-06-02 Research Corp. Technologies, Inc., Tucson Krampfhemmende enantiomere Aminosäurederivate
ES2209728T3 (es) * 1999-08-06 2004-07-01 F. Hoffmann-La Roche Ag Tetrahidro-benzo(d)azepinas y su uso como antagonistas de receptores de glutamato metabotropico.
GB9926898D0 (en) * 1999-11-12 2000-01-12 School Of Earth & Environmenta Calcium silicate sorbents
MXPA03001458A (es) * 2000-08-17 2004-05-04 Teva Pharma Derivados de acido valproico para el tratamiento del dolor.
US20020119944A1 (en) * 2000-11-09 2002-08-29 Michelle Aguera Use of Ulip-and/or Ulip2 in the treatment of myelin disorders
ES2262567T3 (es) * 2001-03-20 2006-12-01 Schwarz Pharma Ag Nuevo uso de una clase peptidica de compuesto para tratamiento del dolor inflamatorio no neuropatico.
ES2185606T3 (es) * 2001-03-21 2003-05-01 Sanol Arznei Schwarz Gmbh Nuevo uso de una clase de compuestos peptidicos para tratamiento de la alodinia u otros tipos diferentes de dolor cronico o fantasma.
ATE517629T1 (de) * 2001-09-07 2011-08-15 Inst Nat Sante Rech Med Verwendung eines proteins der crmp familie zur behandlung von krankheiten des immunsystems
JP4664924B2 (ja) * 2003-12-02 2011-04-06 ウーツェーベー ファルマ ゲーエムベーハー 中枢神経因性疼痛の治療のためのペプチド化合物の新規使用
EP1541138A1 (de) 2003-12-05 2005-06-15 Schwarz Pharma Ag Neue Verwendung von Peptidverbindungen zur Behandlung von Status Epilepticus und ähnlicher Zustände
US20060009384A1 (en) * 2003-12-05 2006-01-12 David Rudd Novel use of peptide compounds for treating status epilepticus or related conditions
US20100256179A1 (en) * 2004-03-26 2010-10-07 Ucb Pharma Gmbh Combination therapy for pain in painful diabetic neuropathy
EP1579858A1 (de) * 2004-03-26 2005-09-28 Schwarz Pharma Ag Neue Verwendung von Peptidverbindungen zur Behandlung von diabetishen Neuropathie
US20070042969A1 (en) * 2004-03-26 2007-02-22 Srz Properties, Inc. Combination therapy for pain in painful diabetic neuropathy
US8008351B2 (en) * 2004-04-16 2011-08-30 Ucb Pharma Gmbh Methods for prophylaxis or treatment of conditions associated with cortical spreading depression
EP1604654A1 (de) * 2004-05-18 2005-12-14 Schwarz Pharma Ag Neue Verwendung von Peptidverbindungen zur Behandlung von Dyskynesien
EP1604655A1 (de) * 2004-06-09 2005-12-14 Schwarz Pharma Ag Neue Verwendung von Peptidverbindungen zur Behandlung von Trigeminusneuralgie
EP1604656A1 (de) * 2004-06-09 2005-12-14 Schwarz Pharma Ag Neue Verwendung von Peptidverbindungen zur Behandlung von amyotropher Lateralsklerose (ALS)
NZ552651A (en) * 2004-08-27 2010-07-30 Sanol Arznei Schwarz Gmbh Novel use of peptide compounds for treating bone cancer pain, chemotherapy-and nucleoside-induced pain
EP1642889A1 (de) * 2004-10-02 2006-04-05 Schwarz Pharma Ag Verbessertes Syntheseschema für Lacosamid
AR057643A1 (es) 2005-01-28 2007-12-12 Sanol Arznei Schwarz Gmbh Lacosamida para terapia adjunta
US20060252749A1 (en) * 2005-01-28 2006-11-09 Srz Properties, Inc. Lacosamide for add-on therapy of psychosis
US20070048372A1 (en) * 2005-08-18 2007-03-01 Srz Properties, Inc. Method for treating non-inflammatory osteoarthritic pain
EP1754476A1 (de) * 2005-08-18 2007-02-21 Schwarz Pharma Ag Lacosamid (SPM 927) zur Behandlung von Myalgien, z.B. Fibromyalgie
US20070043120A1 (en) * 2005-08-18 2007-02-22 Bettina Beyreuther Therapeutic combination for painful medical conditions
EP2037965B1 (de) * 2006-06-15 2017-08-30 UCB Pharma GmbH Pharmazeutische zusammensetzung mit synergistischer antikonvulsiver wirkung
EP1873527A1 (de) 2006-06-30 2008-01-02 Schwarz Pharma Ag Verfahren zur Identifizierung von CRMP-Modulatoren
CN101466390B (zh) * 2006-06-15 2014-03-12 优时比制药有限公司 用于治疗难治性癫痫持续状态的肽类化合物
WO2009053070A1 (en) * 2007-10-23 2009-04-30 Schwarz Pharma Ag Compounds for treating demyelination conditions
AU2011335415B2 (en) * 2010-12-02 2016-05-19 Ucb Pharma Gmbh Once daily formulation of lacosamide
EP2468261A1 (de) * 2010-12-02 2012-06-27 UCB Pharma GmbH Formulierung von Lacosamid

Also Published As

Publication number Publication date
EA018607B1 (ru) 2013-09-30
ES2613931T3 (es) 2017-05-29
TWI422384B (zh) 2014-01-11
CN101636180B (zh) 2012-11-28
JP5795145B2 (ja) 2015-10-14
WO2007144196A2 (en) 2007-12-21
US20140128378A1 (en) 2014-05-08
US20140128377A1 (en) 2014-05-08
EP1873527A1 (de) 2008-01-02
CN101636180A (zh) 2010-01-27
LT2035029T (lt) 2017-02-10
JP2009539910A (ja) 2009-11-19
KR20090030307A (ko) 2009-03-24
EP2035029B1 (de) 2016-11-30
CA2651684A1 (en) 2007-12-21
CN103751157A (zh) 2014-04-30
CY1118523T1 (el) 2017-07-12
BRPI0713702A2 (pt) 2012-10-30
SI2035029T1 (sl) 2017-03-31
MX2008015951A (es) 2009-01-12
PT2035029T (pt) 2017-02-03
AU2007260208B2 (en) 2012-04-12
CN101489591B (zh) 2013-09-11
WO2007144196A3 (en) 2008-08-21
AR061475A1 (es) 2008-08-27
AU2007260208A1 (en) 2007-12-21
TW200815024A (en) 2008-04-01
EP2035029A2 (de) 2009-03-18
KR101517133B1 (ko) 2015-05-04
CN101489591A (zh) 2009-07-22
HUE033180T2 (en) 2017-11-28
PL2035029T3 (pl) 2017-05-31
EA200900021A1 (ru) 2009-06-30
KR20140042926A (ko) 2014-04-07
DK2035029T3 (en) 2017-01-23
US20100273714A1 (en) 2010-10-28

Similar Documents

Publication Publication Date Title
CA2651684C (en) Peptide compounds for treating refractory status epilepticus
US9446011B2 (en) Anticonvulsant combination therapy
AU2005232395B2 (en) Use of peptidic compounds for the prophylaxis and treatment of chronic headache
US20060100157A1 (en) Novel use of peptide compounds for treating pain in painful diabetic neuropathy
CA2740815C (en) New uses for amino acid anticonvulsants
US20060009384A1 (en) Novel use of peptide compounds for treating status epilepticus or related conditions
EP1755577A2 (de) Neue verwendung von peptidverbindungen zur behandlung von amyothropher lateralsklerose
EP1688137A1 (de) SPM 927 zur Co-Therapie der Schizophrenie
EP1541138A1 (de) Neue Verwendung von Peptidverbindungen zur Behandlung von Status Epilepticus und ähnlicher Zustände
KR20070010135A (ko) 통증성 당뇨병성 신경병증의 통증 치료를 위한 펩티드화합물의 신규한 용도

Legal Events

Date Code Title Description
EEER Examination request
MKLA Lapsed

Effective date: 20210615